SummaryLucy Johnston discusses the Power Threat Meaning Framework (PTMF), an alternative to the diagnostic model of distress. The PTMF aims to move away from labeling and medicating distress and instead focuses on narrative practice and understanding. It emphasizes the role of power and the links between personal distress and wider social, political, and economic contexts. The PTMF has received both positive and negative reactions, with some seeing it as radical and threatening existing power structures. Lucy discusses the challenges and criticisms she has faced and the importance of continuing the conversation and promoting alternative narratives.

KeywordsPower Threat Meaning Framework, diagnostic model, distress, narrative practice, power, social context, alternative narratives

Dr Lucy Johnstone is a consultant clinical psychologist, author of 'Users and abusers of psychiatry' (3rd edition Routledge 2021) and ‘A straight-talking guide to psychiatric diagnosis’ (PCCS Books, 2nd edition 2022); co-editor of 'Formulation in psychology and psychotherapy: making sense of people's problems' (Routledge, 2nd edition 2013); and co-author of ‘A straight talking introduction to the Power Threat Meaning Framework’, 2020, PCCS Books) along with a number of other chapters and articles taking a critical perspective on mental health theory and practice. She is the former Programme Director of the Bristol Clinical Psychology Doctorate in the UK and has worked in Adult Mental Health settings for many years, most recently in a service in South Wales. She is Visiting Professor at London South Bank University, and Honorary Fellow of the BPS, and a Fellow of the Royal Society of Arts. Lucy was lead author, along with Professor Mary Boyle, for the ‘Power Threat Meaning Framework’ (2018), a British Psychological Society publication co-produced with service users, which outlines a conceptual alternative to psychiatric diagnosis and has attracted national and international attention. Lucy is an experienced conference speaker and lecturer, and currently works as an independent trainer. She lives in Bristol, UK.

Takeaways

• The Power Threat Meaning Framework (PTMF) offers an alternative to the diagnostic model of distress, focusing on narrative practice and understanding.
• The PTMF emphasizes the role of power and the links between personal distress and wider social, political, and economic contexts.
• The framework has received both positive and negative reactions, challenging existing power structures and identities tied to diagnostic labels.
• It is important to continue the conversation and promote alternative narratives to address the root causes of distress and support well-being.